M1 Group Research Articles

Clinical Outcomes in Middle Cerebral Artery Trunk Occlusions Versus Secondary Division Occlusions After Mechanical Thrombectomy

The benefit of endovascular revascularization of patients with acute ischemic stroke with middle cerebral artery (MCA) secondary division (M2) occlusions as compared with MCA trunk (M1) occlusions is not known. In this analysis, we compared revascularization status and clinical outcomes in patients with angiographically confirmed MCA M1 versus isolated M2 occlusions treated with mechanical thrombectomy using the Merci Retriever devices. We retrospectively analyzed the pooled data of patients with MCA strokes from the Mechanical Embolus Removal in Cerebral Ischemia (MERCI) and Multi MERCI trials. Patient data were dichotomized into 2 groups: MCA M1 occlusions and isolated M2 occlusions. Baseline characteristics, revascularization rates, hemorrhage rates, complications, outcomes, and mortality were evaluated for both groups. Of 178 patients with MCA occlusion treated in the MERCI and Multi MERCI trials, 84.3% had M1 lesions and 15.7% had isolated M2 lesions. Patients with isolated M2 occlusions were revascularized at a higher rate, required a lower mean number of passes, and were associated with a trend toward shorter mean procedure time than patients with M1 occlusions. No statistically significant differences were found between M2 and M1 groups for symptomatic hemorrhage, clinically significant procedural adverse events, favorable 90-day outcome, or 90-day mortality, although in all instances, the M2 outcomes were numerically better than those in M1 subjects. In multivariate analysis, final revascularization was the strongest independent predictor of good outcome at 90 days. Patients with both MCA M1 occlusions and isolated M2 occlusions can achieve a relatively high rate of revascularization and favorable clinical outcomes after mechanical thrombectomy. In fact, patients with isolated M2 occlusions had a higher rate of revascularization, required fewer passes, and had no increased complications compared with patients with M1 occlusions.

1651 PALLIATIVE RADICAL CYSTECTOMY IN PATIENTS WITH METASTATIC BLADDER CANCER - WHAT IS IT WORTH?

You have accessJournal of UrologyBladder Cancer: Invasive/Metastatic Disease I1 Apr 20101651 PALLIATIVE RADICAL CYSTECTOMY IN PATIENTS WITH METASTATIC BLADDER CANCER - WHAT IS IT WORTH? Michael Rink, Sarah Minner, Oliver Balzer, Roland Dahlem, Stefan Balabanov, Hartwig Huland, Margit Fisch, and Felix Chun Michael RinkMichael Rink More articles by this author , Sarah MinnerSarah Minner More articles by this author , Oliver BalzerOliver Balzer More articles by this author , Roland DahlemRoland Dahlem More articles by this author , Stefan BalabanovStefan Balabanov More articles by this author , Hartwig HulandHartwig Huland More articles by this author , Margit FischMargit Fisch More articles by this author , and Felix ChunFelix Chun More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2010.02.1453AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Overall survival in patients with metastatic bladder cancer is limited ranging, in order to the metastatic site and chemotherapeutic treatment, between few months and years. Furthermore these patients often suffer from complications caused by the advanced tumour. Due to their short life expectancy most patients do not receive invasive surgical treatment. We investigated the status of palliative cystectomy in select patients with expected or known primary metastatic bladder cancer. METHODS Between 1996 and 2009, over 400 radical cystectomies (RCX) for treatment of advanced bladder cancer were performed in a single institution. A retrospective analysis of all data regarding patients with pN2 and M1-stage was performed. Statistical analysis controlling for surgical feasibility including operation time, blood loss, blood transfusion, and perioperative complications stratified by the modified Clavien system were performed. As a proxy of QoL, time summaries of hospitalization of all treatment procedures (including surgical and adjuvant therapy) until overall mortality were quantified. Last, overall and cancer specific survival were analysed. RESULTS Median overall survival (OS) was 8 month. 28 patients (48%) died cancer specific. Overall, 58 radical cystectomy patients had pN2 or M1 stage. Of these, 9 (15.5%) patients had M1 (group A) and 49 (84.5%) pN2 (group B) disease, respectively. Mean positive LN density was 43±29%. Median operation time, loss of blood and blood transfusions were 385 min., 1500ml and 3, respectively, without differences between both groups (p=n.s.). Incontinent urinary diversion was used for all patients with M1 and 53% of patientiens with pN2 disease. Postoperative complications occurred in 65% of all patients with major complications in 22%. Mean hospital duration after RCX and overall hospitalization time of all treatment procedures were 25±11 and 46±26 days (range: 12-63 and 15-148) without significant differences between both groups. Overall survival was equally worse in both groups (p=0.9). CONCLUSIONS Palliative cystectomy is feasible in select metastatic bladder cancer patients. However, the rate of early complications is high, overall survival is limited and hospitalization time adds up is about 1/5 of OS. Therefore, palliative cystectomy should be estimated carefully and alternative options have to be discussed with the patients. Hamburg, Germany© 2010 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 183Issue 4SApril 2010Page: e637-e638 Advertisement Copyright & Permissions© 2010 by American Urological Association Education and Research, Inc.MetricsAuthor Information Michael Rink More articles by this author Sarah Minner More articles by this author Oliver Balzer More articles by this author Roland Dahlem More articles by this author Stefan Balabanov More articles by this author Hartwig Huland More articles by this author Margit Fisch More articles by this author Felix Chun More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...

The effect of melatonin replacement and month of treatment after the winter solstice on the reproductive activity of two Mediterranean breeds of sheep

The present experiment assessed the effect of melatonin implants administered between the winter and the summer solstices on the LH release of Rasa Aragonesa and Assaf ewes kept in the absence of males at latitude 41°. Ovariectomized oestradiol-implanted Rasa Aragonesa and Assaf ewes received a single melatonin implant on either 1 January (M1, n = 6 and 4), 15 February (M2, n = 4 and 4), 1 April (M3, n = 4 and 5) or 15 May (M4, n = 4 Rasa Aragonesa, only). Four ewes of each breed did not receive a melatonin implant and were used as controls (C). Between 17 December and 10 September, blood samples were collected twice weekly and assayed for LH. Data from Assaf ewes C groups revealed a higher degree of sexual seasonality, which exhibited a delay in the onset of the reproductive season compared to Rasa Aragonesa ewes (1 September vs. 15 June; P = 0.06). Five Rasa Aragonesa and three Assaf ewes implanted in January responded to melatonin, either by delaying the end of seasonal anoestrus when compared to controls (10 March vs. 29 December and 21 March vs. 22 January, respectively; P < 0.01) or having a short reproductive season (31 days after implantation). Two Rasa Aragonesa and three Assaf ewes responded to melatonin implants on 15 February. None of four Rasa Aragonesa or four Assaf ewes that received melatonin implants on 1 April were induced to resume reproductive activity (P < 0.05 when compared to the M1 groups). These results confirm the efficacy of using melatonin implants shortly after the winter solstice to influence reproductive activity in Mediterranean ewes.

Molecular complexity of successive bacterial epidemics deconvoluted by comparative pathogenomics

Understanding the fine-structure molecular architecture of bacterial epidemics has been a long-sought goal of infectious disease research. We used short-read-length DNA sequencing coupled with mass spectroscopy analysis of SNPs to study the molecular pathogenomics of three successive epidemics of invasive infections involving 344 serotype M3 group A Streptococcus in Ontario, Canada. Sequencing the genome of 95 strains from the three epidemics, coupled with analysis of 280 biallelic SNPs in all 344 strains, revealed an unexpectedly complex population structure composed of a dynamic mixture of distinct clonally related complexes. We discovered that each epidemic is dominated by micro- and macrobursts of multiple emergent clones, some with distinct strain genotype-patient phenotype relationships. On average, strains were differentiated from one another by only 49 SNPs and 11 insertion-deletion events (indels) in the core genome. Ten percent of SNPs are strain specific; that is, each strain has a unique genome sequence. We identified nonrandom temporal-spatial patterns of strain distribution within and between the epidemic peaks. The extensive full-genome data permitted us to identify genes with significantly increased rates of nonsynonymous (amino acid-altering) nucleotide polymorphisms, thereby providing clues about selective forces operative in the host. Comparative expression microarray analysis revealed that closely related strains differentiated by seemingly modest genetic changes can have significantly divergent transcriptomes. We conclude that enhanced understanding of bacterial epidemics requires a deep-sequencing, geographically centric, comparative pathogenomics strategy.

Autonomic nervous system properties in migraine patients and nonmedication treatment in headache free period

Autonomic nervous system properties in migraine patients and nonmedication treatment in headache free period The aim of the study was to characterise parameters of the autonomic nervous system in migraineurs and to find out and to adapt the optimal biofeedback (BFB) training methods. Heart rate (HR), arterial blood pressure and baroreflex sensitivity (BRS) at rest, static workload, arterial occlusion and during recovery period were measured. 22 migraineurs (female, average age 22.2 ± 2.4 years) and 14 healthy age and gender matched controls participated. Migraine patients were divided into two groups (M1 and M2) according to HR and BRS at rest. At rest 60% of migraine patients (group M1) had significantly decreased HR vs. control group (P&lt; 0.01). The M2 group showed a tendency to decreased BRS at rest comparing to the control group and significantly (P&lt; 0.01) differed in this parameter from the M1 group. In a 10 s precontraction period M1 group had a significantly lower HR increase comparing to other analysed groups (P&lt; 0.01). HR was significantly decreased in the M1 group during the recovery period comparing to the control and M2 groups (P&lt; 0.05). Both parts of autonomic nervous system, PNS and SNS branches, were impaired in migraineurs. The M2 group had most likely decreased PNS activity and impaired SNS activity. M1 group patients showed increased PNS activity. BFB training sessions reduced migraine attack frequency and need for medication in the M2 group.

Meeting Report: BioSharing at ISMB 2010

This report summarizes the proceedings of the one day BioSharing meeting held at the Intelligent Systems for Molecular Biology (ISMB) 2010 conference in Boston, MA, USA This inaugural BioSharing event was hosted by the Genomic Standards Consortium as part of its M3 & BioSharing special interest group (SIG) workshop. The BioSharing event included invited talks from a range of community leaders and a panel discussion at the end of the day. The panel session led to the formal agreement among community leaders to join together to promote cross-community knowledge exchange and collaborations. A key focus of the newly formed Biosharing community will be linking up resources to promote real-world data sharing (virtuous cycle of data) and supporting compliance with data policies through the creation of a one-stop-portal of information. Further information about the newly established BioSharing effort can be found at http://biosharing.org.

Memory phase of the cardioprotective effect of isoflurane preconditioning on isolated rat myocardium

Objective To investigate the memory phase of the protective effect of isoflurane preconditioning (IsoP) on rat myocardium. Methods 24 isolated SD rat hearts were divided into four groups: IR, M1, M2 and M3 groups (n=6) according to the time of washout before ischemia. After equilibration, the hearts were perfused for 20 min, 10 min and 0 min in M1, M2 and M3 groups respectively, using Langen dorff apparatus, then received two cycles IsoP and followed by 10 min, 20 min and 30 min washout respectively. All the hearts were subjected to 30 min sustained ischemia and 60 min reperfusion. LVEDP, LVDP, and-dp/ dtmax were recorded. The release of CK and LDH in the outflow and the size of survival myocardium area were measured. Results During reperfusion, the recovery of LVEDP was lower in M1, M2 and M3 groups than that in IR group (P＜0.01). LVDP in M1 and M2 groups increased (P＜0.05). The percentage of recovery of LVDPxHR in M1 and M2 groups at 30 min and 60 min of reperfusion were higher than that in IR group (P＜0.05). The release of CK in memory groups significantly decreased (P＜0.05) and the contents of LDH in M1 group was lower than other groups (P＜0.05). The percentage of survival area of myocardium in M1 and M2 groups was higher than that in IR group and M3 group (P＜0.05). Conclusion The best memory phase of the cardioprotective effect of IsoP is about 20min in isolated rat heart. Key words: Isoflurane preconditioning; Cardiopmtection; Ischemia/reperfusion injury; Memory phase

The efficacy of a double‐layer collagen membrane technique for overlaying block grafts in a rabbit calvarium model

To analyze the outcomes of a single- and a double-layered collagen membrane on the efficacy of onlay block grafts in terms of bone resorption and augmentation. A total of 36 New Zealand white rabbits were used in this study. Calvarial bone blocks were obtained from one side of the parietal bone and fixed on the contaralateral side. The onlay grafts were covered with either no (C group), one (M1 group), or two (M2 group) layers of a non-cross-linked collagen membrane (BioGide((R))). After 2, 4, and 6 months of healing, rabbits were sacrificed and explanted specimens were prepared for histologic and histomorphometric analysis. At each period, the overall pattern of graft bone resorption and membrane biodegradation were examined histologically, and the sustained external form of grafted bone (%) and the remaining mineralized bone volume (%) were measured histomorphometrically. The M1 and M2 groups exhibited decreased bone resorption compared with the C group at all periods. The M2 group had less graft resorption and a higher bone density of the grafted bone than the M1 group. In the M1 group, the collagen membrane was degraded partially or completely by 4 months and was absent at 6 months. Conversely, for the M2 group, the membrane body was retained up to 6 months. Our results demonstrated that the collagen membrane used here can reduce graft bone resorption. Furthermore, the double-layer technique using non-cross-linked collagen membranes (BioGide((R))) can enhance the efficacy of the onlay block bone graft technique in terms of both bone resorption and augmentation compared with a single-layer collagen membrane.

GSTM1 and XRCC3 polymorphisms: Effects on levels of aflatoxin B1-DNA adducts

Objective Aflatoxin B1 (AFB1), which can cause the formation of AFB1-DNA adducts, is a known human carcinogen. AFB1-exposure individuals with inherited susceptible carcinogen-metabolizing or repairing genotypes may experience an increased risk of genotoxicity. This study was designed to investigate whether the polymorphisms of two genes, the metabolic gene Glutathione S-transferase M1 (GSTM1) and DNA repair gene x-ray repair cross-complementing group 3 (XRCC3), can affect the levels of AFB1-DNA adducts in Guangxi Population (n= 966) from an AFB1-exposure area.

Evaluation of a Strategy for Treating Bifurcated Lesions by Single or Double Stenting Based on the Medina Classification

The Medina bifurcated lesion classification has been widely adopted because of its simplicity. However, no data are available on its use in helping select the best stenting technique for bifurcations. Consecutive patients with bifurcated lesions (side branch >or=2.25 mm) were prospectively assessed using the Medina classification. The treatment strategy studied involved implanting two stents in lesions with a Medina classification of 1,1,1 (M3 group) and one stent in only the main vessel in lesions with other Medina classifications (OM group). Clinical endpoints were a major adverse cardiac event (MACE) and target lesion revascularization (TLR) during hospitalization and at 12-month follow-up. The study included 120 patients: 25 in the M3 group and 95 in the OM group. There was no difference in baseline characteristics between the groups. The treatment strategy was successfully implemented in 97% of the OM group and 68% of the M3 group (P< .001). No death or TLR was recorded during hospitalization, though three myocardial infarctions occurred postoperatively (2.1% in the OM group vs 4.0% in the M3 group; P=.6). At 12 months, there was no difference in clinical outcome between the two groups (MACE: 12.6% in the OM group vs 8% in the M3 group; P=.4; TLR: 13.7% in the OM group vs 8% in the M3 group; P=.5). Multivariate analysis showed that bare metal stent implantation (only in patients receiving a single stent) was the only independent predictor of TLR. The planned treatment strategy of implanting a single stent in patients with bifurcated lesions not classified as Medina 1,1,1 lesions was associated with a very low rate of second stent implantation. Moreover, bare metal stent use was a predictor of TLR, suggesting that drug-eluting stents should be used routinely to treat bifurcated lesions regardless of their angiographic complexity.

HER-2/neu in tissue and serum at time of primary diagnosis of breast cancer

e11500 Aim: HER2 in breast cancer tissue is a marker of high prognostic and predictive relevance. Soluble HER-2, the extracellular domain of the HER-2/neu receptor which is shed into the blood, has been suggested to be a helpful tumor marker. We investigated whether there exists a relationship between the concentration of HER-2/neu Shed Antigen in serum (s-HER-2/neu) and HER- 2/neu in breast cancer tissue and whether this relationship could be used for diagnostic purposes. Patients and Methods: s-HER- 2/neu was measured at time of primary diagnosis in the pretherapeutical (presurgical) sera of 525 breast cancer patients with known HER- 2/neu-status in breast cancer tissue. 33 of the patients (6,3%) revealed to have distant metastases (M1). The HER-2/neu- status in tumor tissue was determined by immunhistochemistry, followed by subsequent FISH analysis in case of score 2+. Dako-Score 3+ or 2+ and geneamplification in FISH analysis were regarded as HER-2/neu-positive. HER-2/neu shed antigen was analysed by Immunoassay. Results: For patients without distant metastases (M0) as well as patients with distant metastases (M1) we observed a correlation of s-HER-2/neu with HER-2/neu-status. The median s-HER-2/neu-concentrations were 11.7 ng/ml (13.2 ng/ml) for the HER-2/neu-negative resp. -positive patients in the M0 group (p&lt;0,001) and 11.9 ng/ml (16,0 ng/ml) in the M1 group (p=0,01). In 492 M0-patients we performed a ROC-analysis in order to investigate the diagnostic capacity of s-HER-2/neu concerning its predictive value for the HER-2/neu-status: using a cut off value of 30 ng/ml the HER-2/neu-status was always positive, corresponding to a specificity of 100% and a sensitivity of 7.7 %. Conclusions: There is a correlation between high s-HER-2/neu-values and a positive HER-2/neu-status. Pretherapeutical s-HER- 2/neu-values ≥30 ng/ml were only observed in HER-2/neu-positive patients. HER-2/neu shed antigen in serum can add up to the HER-2/neu-status and might reveal false-negative tissue findings. [Table: see text]

Lineages of varicella-zoster virus

Relationships among varicella-zoster virus (VZV; Human herpesvirus 3) genome sequences were examined to evaluate descent of strains, structures of lineages and incidence of recombination events. Eighteen complete, published genome sequences were aligned and 494 single nucleotide polymorphisms (SNPs) extracted, each as two alleles. At 281 SNPs, a single sequence differed from all the others. Distributions of the remaining 213 SNPs indicated that the sequences fell into five groups, which coincided with previously recognized phylogenetic groupings, termed E1, E2, J, M1 and M2. The 213-SNP set was divisible into 104 SNPs that were specific to a single group, and 109 cross-group SNPs that defined relationships among groups. This last set was evaluated by criteria of continuities in relationships between groups and breaks in such patterns, to identify crossover points and ascribe them to lineages. For the 99 cross-group SNPs in the genome's long unique region, it was seen that the E2 and M2 groups were almost completely distinct in their SNP alleles, and the E1 group was derived from a recombinant of E2 and M2. A valid phylogenetic tree could thus be constructed for the four E2 and two M2 strains. There was no substantive evidence for recombination within the E2 group or the E1 group (ten strains). The J and M1 groups each contained only one strain, and both were interpreted as having substantial distinct histories plus possible recombinant elements from the E2 and M2 lineages. The view of VZV recombination and phylogeny reached represents a major clarification of deep relationships among VZV lineages.

Effect of epidural midazolam on the epidural analgesia with sufentanil after gynecological operation

Objective To evaluate the effect of different doses of midazolam administered epidurally on the epidural analgesia with sufentanil after gynecologic operation. Methods One hundred and twenty ASA patients aged 30-50 yr with body weight index<30 kg/m2 undergoing abdominal gynecological operation under epidnral anesthesia received continuous epidnral infusion of sufentanil for 48 h (a loading dose of 10 ml of sufentanil+continuous infiusion at 2 ml/h) after operation. The patients were randomly allocated to one of 4 groups (n=30each):group Ⅰcontrol (C) received epidural sufentanil only; group Ⅱ, Ⅲ , Ⅳ received epidural sufentanil +epidural midazolam 0.025 mg/kg (M1), 0.050 mg/kg (M2) and 0.075 mg/kg (M3) respectively. Epidural catheter was placed at L1.2 or L2.3 interspace. The severity of postoperative pain was assessed with an 100 cm VAS score. Adequate analgesia was defined as VAS score of ≤ 30 cm. Echo of epidural sufentanil was determined by up-and-down sequential technique. The initial sufentanil concentration was 1 μg/ml. Each time the concentration of epidural sufentanil increased/decreased by 20% of the previous concentration. The level of sedation was evaluated with Ramsay sedation score (1=fully awake, 6=asleep, unresponsive to verbal stimulus). The side effects were also recorded. Results The EC50 of sufentanil and 95% confidence interval were 0.87 ('0.79-0.96),0.82(0.74-60.90), 0.67 (0.61-0.74) and 0.63 (0.56-0.71) μg/ml respectively in group C, group M1, M2 and M3. EC50 was significantly lower in group M2 and M3 than in group C. The Ramsay sedation score was in the order of group M3 group M2 group M1 and group C (P<0.05). The incidences of over-sedation and respiratory depression were significantly higher in group M3 than in other 3 groups. Conclusion Epidural midazolam 0.050-0.075 mg/kg can enhance the analgesic effect of epidural sufentanil after gynecological operation. Key words: Sufentanil; Midazolam; Dose-response relationship, drug; Analgesia, epidural; Gynecologic surgical procedures

Proposal to Subclassify Stage IV Gastric Cancer Into IVA, IVB, and IVM

This study examined the prognosis of patients with stage IV gastric cancer by subgroups after surgical treatment. Retrospective study. Tertiary care referral center. A total of 1056 patients with stage IV gastric cancer who underwent gastrectomy from January 1, 1995, through December 31, 2006, were divided into the following 3 groups: T4N1-3M0 (group 1), T1-3N3M0 (group 2), and T(any)N(any)M1 (group 3). The clinicopathological characteristics, recurrence pattern, and survival were compared among the 3 groups. There was a significant difference in the surgical curability, operation type, Lauren classification, histological differentiation, lymphatic invasion, number of lymph nodes retrieved, and adjuvant therapy among the 3 groups. The 5-year survival rates in groups 1, 2, and 3 were 18.3%, 27.1%, and 9.3%, respectively (P < .001). After R0 resection, locoregional recurrence (40.9%) followed by peritoneal recurrence (27.3%) was most common in group 1, whereas distant (30.2%) and peritoneal recurrence (26.7%) were most common in group 2. Multivariate analysis showed the following significant prognostic factors for survival: surgical curability and adjuvant therapy for group 1; surgical curability, surgical extent, adjuvant therapy, and number of retrieved lymph nodes for group 2; and surgical extent and chemotherapy for group 3. Each subgroup of stage IV gastric cancer had different clinical outcomes, including histological behavior, recurrence pattern, survival, and prognostic factors. Therefore, subclassification of stage IV gastric cancer into IVA (T1-3N3M0), IVB (T4N1-3M0), and IVM (T[any]N[any]M1) might be useful for a more accurate prediction of prognosis and selection of appropriate therapeutic options.

Study on relationship between fat-rich diet-induced nonalcoholic fatty liver disease and endoplasmic reticulum stress in rats

Objective To establish the nonalcoholic fatty liver disease(NAFLD) model in SD rats and to investigate if endoplasmic reticulum stress(ERS) plays a role in the pathogenesis of NAFLD. Methods A total of 36 male SD rats were randomly divided into 4 groups: normal control group 1(N1,n=8), normal control group 2 (N2,n=8), model group 1(M1,n=10) and model group 2(M2,n=10). The two control groups were fed with normal diets, whereas the two model groups were provided diets enriched in fat (10% lard oil and 2% cholesterol). The rats in N1 and M1 groups were sacrificed at the 12th week, and those in N2 and M2 groups were sacrificed at the 20th week. The serum alanine aminotransferase (ALT), aspartate aminotransferase(AST), alkaline phosphatase (ALP), total protein (TP), triglycerides (TG), total cholesterol (TC), low-density lipoprotein (LDL), high-density lipoprotein (HDL) were measured. The steatosis, immflamation and fibrosis of the liver were observed with HE and Masson staining. The expressions of GRP78, CHOP and procaspase-12 mRNA were tested using real-time PCR and the activation of procaspase-12 protein was detected by Western blot. Results At the 12th week, the liver index and the serum levels of ALT, AST,ALP,TP,TC,LDL in M1 group were significantly higher than those in N1 group (P<0.01), but HDL level was significantly lower in M1 group than that in N1 group (P<0.01). At the 20th week, the concentrations of TC and LDL in M2 group were significantly increased in comparison with N2 group. The histochemical study revealed that the hepatic steatosis and inflammation in M1 and M2 groups were more serious than those in N1 and N2 goups(P<0.01). The slight fibrosis was seen in M2 group. At the 12th and 20th weeks, the expressions of GRP78,CHOP and procaspase-12 mRNA and protein in M1 and M2 groups did not differ in N1 and N2 groups. Conclusions The fat-rich diet might successfully induce NAFLD in rats and there is no ERS observed in the study, which suggests that ERS may not be involved in the pathogenesis of NAFLD. Key words: Fatty liver; Endoplasmic reticulum; Disease models, animal

The effect of seamustard on blood lipid profiles and glucose level of rats fed diet with different energy composition

Recently, Korean people are consuming seaweeds almost 3.5 times more now than three decades ago. It is well known that seaweeds contain lots of soluble dietary fiber in addition to micronutrients such as β-carotene, iodine and some bioactive components. Seaweeds are considered to be effective for preventing chronic diseases including obesity, diabetes mellitus, atherosclerosis, cancer or constipation. This study was conducted to investigate the effect of seamustard intake on body weight gain, blood glucose level and lipid profiles in rats fed diets with different energy nutrient composition. Male Sprague-Dawley rats (average initial weight 103.7 g) were divided into groups for two experiments as follows; Control, M2.5 & M5 groups (Exp. I) and M5, M10, HCM5, HCM10, HFM5 & HFM10 groups (Exp. II). The rats were fed diet and water ad libitum for 4 weeks. In general, there was no significant difference in blood glucose and triglyceride concentration among groups. In Exp. I, serum LDL-cholesterol level of rats fed diet with 5% seamustard powder (M5) was significantly lower than that of control group, while HDL-cholesterol level, TC/LDL ratio and weight of adrenal gland were higher. In Exp. II, food intake, body weight gain and EER of high fat diet with 10% seamustard group (HFM10) were the lowest among groups. Except gastrocnemius muscle, all organ weights of HFM10 group were the lowest. Fecal cholesterol excretion and serum LDL-cholesterol concentration of HFM10 group were the highest, while serum HDL-cholesterol level was the lowest among groups. Interestingly, HDL-cholesterol concentration was the highest in HCM5 group among groups. From these results, it was suggested that seamustard intake might be more effective for body weight control, but not for improving blood lipid profiles in high fat diet than in high carbohydrate diet.

Structural and Functional Relationships in Glaucoma Using Standard Automated Perimetry and the Humphrey Matrix

PurposeTo evaluate and compare correlations between structural and functional loss in glaucoma as assessed by optical coherence tomography (OCT), scanning laser polarimetry (GDx VCC, as this was the model used in this study), standard automated perimetry (SAP), and the Humphrey Matrix (Matrix).MethodsNinety glaucomatous eyes identified with SAP and 112 eyes diagnosed using Matrix were independently classified into six subgroups, either S1/M1 (MD>-6dB), S2/M2 (-12<MD<-6dB) or S3/M3 (MD<-12dB), according to the mean deviation (MD) of each test. Average and sectoral retinal nerve fiber layer (RNFL) thickness and percentage of abnormal classifications using the internal normative databases of OCT and GDx VCC were compared among the six subgroups.ResultsIn the SAP subgroups, RNFL thickness values obtained by OCT in the nasal and temporal quadrants and the inferior averages of GDx VCC did not differ between the S1 and S2 subgroups (p=0.137, 0.738 and 0.149, respectively). In the Matrix subgroups, no measurement parameters differed between the M1 and M2 groups except for the overall mean and average inferior RNFL thickness given by OCT and the NFI values of GDx VCC (p=0.013, 0.016 and 0.029, respectively). When abnormal classifications were compared, all measurement parameters, without exception, were significantly different in both the SAP and the Matrix subgroups.ConclusionsSAP subgroups showed a good correlation of structural and functional defects when assessed using OCT and GDx VCC. These correlations were weaker in the Matrix subgroups, especially in the early stages of glaucoma.

Eine additive Therapie chronischer Schmerzen bei fortgeschrittener Gon-/Coxarthrose mit dem selektiven Serotonin-Reuptake-Hemmer Fluvoxamin (Fevarin®)

The aim of this study was to investigate the effectiveness and safety of the selective serotonin reuptake inhibitor fluvoxamine (Flevarin) in patients with a chronic pain syndrome due to hip and knee arthritis. We prospectively investigated 60 patients in a single-centre double-blind study. The group was divided into two groups (M1 fluvoxamine; M2 placebo) each containing 30 patients, age ranging from 30 to 80 years. During treatment results were evaluated using several scales once at the beginning (V1) followed by weekly evaluations (V1-V8) and one final investigation at the end of treatment (V9). The investigated medication consisted of 50-150 mg fluvoxamine. In addition other drugs such as NSAID were administered (diclofenac, piroxicam, ibuprofen). Both groups (M1 and M2) showed a reduction of pain during treatment using the visual analogue scale (VAS). However, no statistical difference was found between both groups concerning pain reduction at any time. A significant pain relief was monitored in the patients of the M1 group towards the end of treatment. Concerning the daily impairment because of pain measured by the Griss scale an improvement was seen in 70 % of the patients receiving fluvoxamine versus 44 % in patients receiving placebo. Additionally, an improvement in the M1 group was seen in the WOMAC scale and in factors such as pain, stiffness and mobility compared to the M2 group. Using the CGI scale, 56.6 % of the M1 group compared to 37.9 % of the M2 group were stating that their overall status had improved "much" or "very much" at the end of the treatment (V9). A depression had been excluded in all patients. No statistical differences were seen in the Bf scale (von Zerssen) during all evaluations (V1 to V9). During the whole study 127 side effects were registered in 49 patients. None of the 5 severe events were related to the investigated drug. Considering the good effects in combination with very few side effects, a positive cost-effectiveness relation for the usage of fluvoxamine can be stated in patients with chronic pain syndrome due to hip and knee arthritis.

Comparison of real intraocular pressure (IOP) during LASIK versus Epi‐LASIK

Abstract Purpose To compare real‐time intraocular pressure (IOP) in LASIK versus Epi‐LASIK in porcine eyes during flap creation using the Moria 2 microkeratome and the Moria Epi‐KTM epikeratome. Methods Interventional, prospective study of two keratomes: Moria Group (M2) and epipolis laser in situ keratomileusis Group (MEpi‐K). These devices were used to create a lamellar corneal or epithelial flap respectively in freshly enucleated porcine eyes. The IOP changes induced by the procedures were recorded using manometry by direct cannulation with a reusable blood pressure transducer connected to the anterior chamber. Results 7 eyes were included for M2 Group and 10 for the MEpi‐K Group. In the M2 Group the IOP increased during suction phase to a mean value of 122.53±30.40 mm Hg and to 160.52±22.73 mm Hg during cutting phase (mean time: 21.42±7.48 and 15.71±1.88 secs respectively). In the MEpi‐K Group, mean IOP increase was 100.66±18.60 mm Hg during suction phase, 91.38±17.79 mm Hg during cutting phase and 74,37±12.70 during low‐back phase (mean time: 25.79±3.44, 33.68±2.81 and 29.74± 3.11 secs respectively). IOP values in both groups showed statistical significant difference in all comparison (p&lt;0.01). Conclusion Real‐time IOP can be measured during flap creation process using direct manometry in the anterior chamber. Our results show a significant increase in IOP during the surgical procedure in both groups although the IOP increase reached with MEpi‐K epikeratome seems to be lower than M2 microkeratome.

Correlation of Matrix Metalloproteinases and Tissue Inhibitors of Matrix Metalloproteinase Expression in Ileal Carcinoids, Lymph Nodes and Liver Metastasis with Prognosis and Survival

Purpose: Ileal carcinoids are gut epithelial tumors originating from serotonin-containing enterochromaffin (EC) cells. Therapeutic options for effectively inhibiting the growth and spread of metastatic carcinoids are still limited. We aimed to identify the role of matrix metalloproteinases (MMPs) and their endogenous tissue inhibitors (TIMPs) during tumor development and metastasis. Patients and Methods: Tissue samples were obtained from surgically treated patients. Expression of the EC-cell marker, vesicular monoamine transporter-1 (VMAT-1), was used to verify ileal carcinoids. We investigated the differential expression of MMP-2, 7, 9, 11, and 13 and their endogenous inhibitors (TIMP-1, 2, and 3) by quantitative real-time RT-PCR in 25 primary tumors, their corresponding lymph node metastases and/or liver metastases and matched normal mucosa. Results: Significantly increased expression of VMAT-1, MMP-2, MMP-11, TIMP-1 and TIMP-3 was determined by quantitative RT-PCR in EC-cell carcinoids compared to normal intestinal mucosa (p < 0.05). In contrast, MMP-2 and MMP-9 as well as TIMP-1, TIMP-2, and TIMP-3 expression in primary tumors of patients with liver metastases (M1) was significantly lower than in patients lacking liver metastases (M0). EC-cell tumors were significantly larger in the M1 group of tumors, while VMAT-1 expression was significantly decreased. We found an inverse correlation between tumor size and prognosis. Univariate analysis further revealed that decreased expression of VMAT-1, MMP-2 and TIMP-3 in primary tumors was significantly associated with a reduced survival time of the patients. Conclusion: Our data reveal that MMP-2 and TIMP-3 expression together with VMAT-1 expression are of potential prognostic and clinical value in ileal carcinoids.